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目的 分析老年肺癌术后心律失常 ,探讨其发生机制和防治措施。方法 分析 1994年 2月～ 2 0 0 0年 2月老年肺癌手术 32 9例 ,术后发生心律失常 94例 ,选择术前相关因素为术前心电图、肺功能和血氧饱和度 ;术中为年龄 ,麻醉和全肺切除与否 ;术后肺部其他合并症等因素作为分析证据。结果 老年肺癌手术后发生心律失常 ,比 6 0岁以下的术后发生率明显增高 (2 8.6 % vs 15 .6 % ,P<0 .0 1) ;其中心电图异常 ,血氧饱和度低 ,全肺切除以及术后肺部炎症是心律失常发生的主要因素。结论 术前积极治疗心脏原发病 ,纠正低氧 ;严格掌握全肺切除适应证 ;术后吸氧 ,雾化吸入预防肺部炎症是防止发生心律失常的根本措施。控制心室率 ,抗凝以及恢复并维持窦性心律是治疗的关键
Objective To analyze the postoperative arrhythmia in elderly patients with lung cancer, and to explore its mechanism and prevention measures. METHODS: From February 1994 to February 2000, 299 elderly lung cancer patients were treated and 94 postoperative arrhythmias were performed. Preoperative correlative factors were preoperative electrocardiogram, pulmonary function, and oxygen saturation; intraoperatively Age, anesthesia, and pneumonectomy or other postoperative pulmonary complications were used as analysis evidence. [Results] Arrhythmia occurred in elderly lung cancer patients after operation, which was significantly higher than that after 6 years of age (28.6 % vs 15.6%, P < 0.01). The central electrogram was abnormal, and the oxygen saturation was low. Pulmonary resection and postoperative pulmonary inflammation are major factors in the occurrence of arrhythmia. Conclusion Preoperative treatment of primary cardiac disease and corrective hypoxia are necessary. Strict control of indications for pneumonectomy is strictly followed. Postoperative oxygen inhalation and nebulized inhalation to prevent pulmonary inflammation are fundamental measures to prevent arrhythmia from occurring. Control of ventricular rate, anticoagulation, and recovery and maintenance of sinus rhythm are the keys to treatment